Sexual behaviors, substance use, and condom use in a sexually transmitted disease clinic sample

In many studies, alcohol and drug use is clearly associated with behaviors that put individuals at risk for sexually transmitted diseases (STDs). However, the nature of the association remains unclear. In this study we examined the relationship of condom use with substance use in adults with other sex partners (N = 508) who were seeking services in an STD clinic, engaged in high levels of risky sexual behaviors, and also engaged in high levels of alcohol and drug use with sex. We also compared the behaviors with steady and casual partners. We hypothesized that condom use would decrease with increasing levels of substance use with both partner types. That hypothesis was not supported: Condom use was not associated with substance use with either partner type. Although respondents reported significantly higher levels of substance use and intoxication with casual than with steady partners, they also reported significantly higher levels of condom use with casual partners. Interventions based on the assumption of a causal relationship between substance use and risky sex are not supported in this high risk heterosexual sample.